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Description/Abstract

SummaryBackground: Osteoarthritis (OA) of the knee is themost prevalent joint disorder. Previous studiessuggest that bromelain, a pineapple extract, maybe a safer alternative/adjunctive treatment for kneeOA than current conventional treatment.Aim: To assess the efficacy of bromelain in treatingOA of the knee.Design: Randomized, double-blind placebocontrolledtrial.Methods: Subjects (n¼47) with a confirmed diagnosisof moderate to severe knee OA wererandomized to 12 weeks of bromelain 800 mg/dayor placebo, with a 4-week follow-up. Knee (pain,stiffness and function) and quality-of-life symptomswere reported monthly in the WOMAC andSF36 questionnaires, respectively. Adverse eventswere also recorded. The primary outcomemeasure was the change in total WOMAC scorefrom baseline to the end of treatment at week 12.Longitudinal models were used to evaluateoutcome.Results: Thirty-one patients completed the trial(14 bromelain, 17 placebo). No statistically significantdifferences were observed between groups forthe primary outcome (coefficient 11.16, p¼0.27,95%CI 8.86 to 31.18), nor the WOMAC subscalesor SF36. Both treatment groups showed clinicallyrelevant improvement in the WOMAC disabilitysubscale only. Adverse events were generally mildin nature.Discussion: This study suggests that bromelain is notefficacious as an adjunctive treatment of moderateto severe OA, but its limitations support the need fora follow-up study.